Meta-analysis Of CSF Diversion Procedures In The Setting Of Idiopathic Intracranial Hypertension

BACKGROUND AND PURPOSE: Although CSF shunting is considered the next line of management in medically refractory idiopathic intracranial hypertension, the evaluation of its application is rather rare. We underwent the largest domestic meta-analysis of articles about VPS shunting and LPS shunting in the setting of IIH, which was the only one to our knowledge then. Now, the results and our conclusions present in this paper.MATERIALS AND METHODS: We performed a thorough search of all peer-reviewed articles published between 1988 and 2014 for IIH patients who had received a CSF shunting procedure, extracted data to draw a spreadsheet, and tried to conceal the general law of CSF shunting treatment of IIH patients by make utility of the chi square tests on the rates of qualitative data.RESULTS: The analysis included 435 patients from 17 articles. Post-procedure, there was improvement of vision in 54%, headache in 80%, and papilledema in 70%; 43% of patients required at least 1 additional surgery. The major and minor complication rates were 7.6% and 32.9%, respectively. The chi square tests on the relief rates of headache, papilledema and visual loss; incidence rates of shunting failure and post-operative low ICP had significance meanings, while others, including shunting revision rates and incidence rates of shunting obstruction revealed negative results.CONCLUSIONS: Despite great limitations, our study showed the similarities and differences of the effectiveness and complications between patterns of CSF shunting on IIH complaints. However, all opinions here need the verification by the prevailing RCTs or observational studies.